Where Back Pain Begins

Eighty percent of the population of the United States, at some point in their life, suffers from back pain. Most of the time, that pain is centered in the lower back and non-specific, meaning there is no primary cause found. About 2% to 10% of people who experience low back pain develop chronic low back pain, which affects daily living for at least 3 months. Generally speaking, the lower back is subject to a lot of mechanical stress and strain. The vertebral discs are the spinal column’s shock absorbers. The discs cushion the vertebral bones and allow the spine to twist and bend. When vertebral discs are damaged by the normal wear of aging or by traumatic injury the results are frequently low back pain.

Where Neck Pain Begins

Neck pain is a common problem that can result from poor posture, wear and tear, overuse, or traumatic injury to the cervical spine. Neck pain can last for a few hours or days, or it can be a chronic problem that lasts for weeks or years.

Herniated Discs

A herniated disk refers to a problem with one of the rubbery cushions (disks) between the individual bones (vertebrae) that stack up to make your spine.

A spinal disk is a little like a jelly donut, with a softer center encased within a tougher exterior. Sometimes called a slipped disk or a ruptured disk, a herniated disk occurs when some of the softer “jelly” pushes out through a crack in the tougher exterior.

A herniated disk can irritate nearby nerves and result in pain, numbness or weakness in an arm or leg.

Migraine Headaches

A migraine is an intense, throbbing headache that may be accompanied by nausea or dizziness. A migraine can last from hours to days.

A migraine headache can cause intense throbbing or a pulsing sensation in one area of the head and is commonly accompanied by nausea, vomiting, and extreme sensitivity to light and sound.

Migraine attacks can cause significant pain and can last from hours to days. Some migraines are preceded or accompanied by sensory warning symptoms (aura), such as flashes of light, blind spots, or tingling in your arm or leg.

Carpal Tunnel Syndrome

The carpal tunnel is a passageway in the wrist formed by the carpal ligament and the bones of the hand. This passageway protects the hand’s main nerve (called the median nerve).

Carpal Tunnel Syndrome is a painful compression of this nerve in the wrist. It can interfere with a person’s ability to use the wrist and/or hand. Carpal tunnel syndrome is a progressive condition that can worsen without proper care.

Concussion

This common brain injury is caused by an impact to the head or upper body. A concussion interferes with brain function. In most cases the effects are mild and temporary, and the concussion does not cause permanent injury. But a concussion is a serious injury that can cause lasting brain damage or death if not treated properly.

Epilepsy

This condition is a chronic neurological disorder characterized by seizures. A seizure is a surge of electrical energy caused by a misfiring of neurons in the brain. These abnormal signals can severely disrupt the body’s sensory and motor systems. A person may be diagnosed as epileptic after experiencing two or more seizures.

Magnetic Resonance Imaging (MRI)

This noninvasive medical imaging technique uses a powerful magnetic field to create a detailed three-dimensional view of the inside of the body. The images it produces are similar to those generated by a CT scan. However, MRI images provide a much clearer view of soft tissues. This makes MRI a valuable diagnostic tool for the visualization of cancer, infection, internal bleeding and soft tissue trauma.

Electromyography (EMG)

This outpatient diagnostic test is used to evaluate the health of muscles and the nerves, called motor neurons, which control the muscles. EMG is a valuable diagnostic device for determining the cause of muscle weakness and for identifying neurologic disorders.

Nerve Conduction Study (NCS)

This noninvasive, outpatient exam is used to measure how quickly nerves conduct electrical signals through the body. NCS is a valuable technique for diagnosing nerve damage. If damage exists, NCS can help a physician find its source.

Cervical Facet Radiofrequency Neurotomy

This minimally-invasive procedure, also called radiofrequency (or RF) rhizotomy, reduces or eliminates the pain of damaged facet joints by disrupting the medial branch nerves that carry the pain signals. This procedure is performed with local anesthetic.

Cervical Epidural Steroid Injection

This injection relieves pain in the neck, shoulders, and arms caused by a pinched nerve (or nerves) in the cervical spine. Conditions such as herniated discs and spinal stenosis can compress nerves, causing inflammation and pain. The medication injected helps decrease the swelling of nerves.

Facet Joint Injections

The facet joints, found on both sides of the back of the spine, can become painfully irritated or inflamed. A facet joint injection may help diagnose the source of a patient’s pain. It can also relieve pain and inflammation.

Intrathecal Pump Implant

An intrathecal pump relieves chronic pain. It uses small amounts of medicine applied directly to the intrathecal space (the area surrounding the spinal cord) to prevent pain signals from being perceived by the brain. Pump candidates include people for whom conservative treatments have failed and surgery is not likely to help.

Lumbar Epidural Steroid Injection

Lumbar Radiofrequency Neurotomy

This minimally-invasive procedure, also called radiofrequency (RF) rhizotomy, reduces or eliminates the pain of damaged facet joints by disrupting the medial branch nerves that carry the pain signals. This procedure is performed with local anesthetic.

Medial Branch Block

Sacroiliac Joint Steroid Injection

This injection procedure is performed to relieve pain caused by arthritis in the sacroiliac joint where the spine and hip bone meet. The steroid medication can reduce swelling and inflammation in the joint.

Spinal Cord Stimulator Implant

Spinal cord stimulation (also called SCS) uses electrical impulses to relieve chronic pain of the back, arms and legs. It is believed that electrical pulses prevent pain signals from being received by the brain. SCS candidates include people who suffer from neuropathic pain and for whom conservative treatments have failed.

ACL Reconstruction

Joint Arthroscopy

Arthroscopic surgery is used to diagnose and treat many joint problems. This significant advance in joint care allows for a rapid return to improved activity. Most commonly used in knees, shoulders and ankles, the arthroscope can also be used for the spine, hips, wrists, and elbows. This animation shows the knee joint.

Meniscus Transplant

The meniscus is comprised of two c-shaped wedges of cartilage that cushion and stabilize the knee joint. This outpatient arthroscopic procedure replaces lost or severely damaged meniscal cartilage with tissue taken from a donor knee. The surgery lasts about one to three hours and is performed under general anesthetic.

Total Knee Replacement

This procedure restores function to a severely damaged knee. Most commonly, it is used to repair a knee that has been damaged by arthritis. During the procedure, the surgeon replaces the damaged portions of the knee with artificial parts. These parts consist of a metal femoral component, a metal tibial component and a plastic spacer. A small plastic patellar component may also be used.

Rotator Cuff Repair

This surgical procedure is used to repair a torn supraspinatus tendon, one of the tendons that forms the rotator cuff of the shoulder. During this procedure, the tendon is reattached firmly to the head of the humerus.

Ankle Fracture Surgery

This surgical procedure is used to correct a fracture of the fibula or tibia in the ankle joint. The procedure involves attachment of a fixation plate made of stainless steel or titanium to the fibula and use of screws or fixation plate on the tibia to stabilize the bones and allow healing.

Plantar Fascia Release (Open Technique)

This outpatient procedure is a surgical cutting of part of the plantar fascia, a thick band of connective tissue that supports the foot’s arch. By partially cutting this tissue, the surgeon releases tension and allows the tendon to lengthen. This procedure is commonly performed to relieve pain caused by plantar fasciitis.

Basal Joint Surgery

Pain in the basal joint caused by arthritis makes it difficult for patients to grip and hold or twist objects between the thumb and fingers. This surgical procedure removes and rebuilds the basal joint.